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| SONG Zhengdong,SONG Wenhui,LIU Changwen.Relationship between clinical factors and the volume change of vertebral "shell" after thoracolumbar burst fractures after surgery[J].Chinese Journal of Spine and Spinal Cord,2018,(11):1011-1019. |
| Relationship between clinical factors and the volume change of vertebral "shell" after thoracolumbar burst fractures after surgery |
| Received:August 28, 2018 Revised:November 04, 2018 |
| English Keywords:Thoracolumbar burst fractures "Shell" phenomenon Resorption rate Influencing factor |
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| English Abstract: |
| 【Abstract】 Objectives: To analyze the relationship between the volume change of vertebral "shell" and clinical factors after posterior distraction and indirect decompression of thoracolumbar burst fractures. Methods: Totally 52 patients with thoracolumbar single-segment burst fractures undergoing open reduction and indirect decompression and internal fixation in our department from January 2016 to January 2018 were reviewed. CT- three dimentional reconstruction was performed on these patients before surgery, within 3 days after surgery, and at 6 months after surgery. The volume of vertebral "shell" was calculated by 3D-CT images. The ratio of the volume of bone fragments at 6 months after surgery to those immediately after the surgery was called resorption rate. The ratio of the volume change of vertebral "shell" at 6 months after surgery to that immediately after surgery was called the rate of volume change. Possible factors affecting the rate of volume change of vertebral "shell" included age, gender, location, fracture segment, fracture type, preoperative compression rate of vertebra, resorption rate, recovery rate of the anterior height of vertebral body after operation and recovery rate of Cobb angle. Single factor and multi-factor logistic analysis were used to study the correlation between these factors and the rate of volume change of vertebral "shell". Results: The rate of volume change of vertebral "shell" had no correlation with age, gender, BMI, smoking, intervertebral disc injury location, fracture type, recovery rate of Cobb angle(P>0.05). Single factor analysis showed that the rate of volume change of vertebral "shell" was significantly correlated with preoperative compression rate of vertebral body, resorption rate and recovery rate of the anterior height of vertebral body after operation(P<0.05). Multi-factor analysis showed that preoperative compression rate(t=-2.47) of vertebral body and resorption rate(t=5.06) were the main influencing factors of the rate of volume change of vertebral "shell". Preoperative compression rate of vertebral body had a negative influence on the rate of volume change of vertebral "shell" while the resorption rate had a positive effect on the rate of volume change of vertebral "shell"(P<0.05). Conclusions: The volume change of vertebral "shell" after thoracolumbar burst fracture with open reduction, indirect decompression and internal fixation is influenced by many factors. The preoperative compression rate of vertebral body and resorption rate are the main influencing factors. |
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